What is Melasma?

Melasma is a skin condition where brown pigmentation forms on the cheeks, around the eyes, on the forehead, or above the lip.

While anyone from light-skinned redheads to dusky brunettes can develop it, it is more common among darker skin types and people who have the ability to tan easily like South Asians, Hispanics, and Italians. It also affects both men and women.

What causes Melasma?

It is often difficult to pinpoint the exact cause of melasma as it varies from person to person. Below are some of the known causes:

If you are looking to clear your melasma, the first step is to pinpoint the cause. Once you figure out the cause, you can find the appropriate ways to tackle the problem at the root.

The best people to answer this is your doctor — who can test your levels of estrogen and progesterone — and you — since you can trace back to when your melasma first started and what you did before (i.e. medication/lifestyle/diet/habits).

For now at least, I will focus on the most common cause of melasma – hormone imbalances.

Common Causes of Hormone Imbalances

Hormonal changes due to pregnancy is perhaps the most common cause (in fact, melasma is sometimes referred to as the pregnancy mask).

However, you don’t need to be pregnant to have your hormone levels be out of whack these days. Unfortunately, we are bombarded by chemicals, pesticides, and food additives that can easily have the same effect on our hormones. These compounds are called xenoestrogens.

Apart from pregnancy, melasma due to hormonal changes can be due to causes like:

Excessive copper levels in the body. Copper is closely related to the metabolism of the estrogen hormone.

It is interesting to note that the third cause—an excess of copper—can also be related to pregnancy. Copper levels are usually elevated in pregnant women as the mineral is needed to form new blood cells for the foetus.

If you are on a vegetarian diet, it is likely that your copper levels are also elevated because of the type of proteins you ingest.

Hormone Imbalances or Estrogen Dominance

The subject of estrogen dominance is a tricky one.

If you have time to spare, I suggest reading up on the information found here. The page describes estrogen dominance at length and will be useful for anyone seeking more in-depth knowledge on the matter. It also discusses several methods to detoxify your body of excess estrogens.

Also read Jane’s story, which is a case study of a woman that has struggled with the issue all her life. What struck me was that at one part of her tale, she describes that “hyper-pigmentation would appear on her face whenever she had her periods”. Although melasma is never mentioned in these pages specifically, Jane’s comment is no doubt too similar to the condition related to melasma to ignore.

I’ve summarised several significant points from the site below:

For optimum health, the progesterone to estrogen ratio should be between 200 – 300 : 1.

Countries with higher obesity rates tend to show more incidence of estrogen dominance in the population. All body fat has an enzyme which converts adrenal steroids to estrogen, so the more fat you have, the more estrogen is present. However, plants contain over 5,000 known sterols that have progestogenic effects (counteracts estrogen), so a switch to a healthier, more plant-based diet will help lower estrogen levels.

Taking drugs and alcohol may contribute to higher estrogen levels as these impair the liver which is the main organ that breaks down the estrogen hormone. This also means that taking herbs/supplements that aid in liver function will detoxify the body of too much estrogen. A sterling example is milk thistle (silybum marianum), which has been proven to fortify the liver. The dosage for milk thistle is 70 to 200 mg one to three times a day.

Vitamin B6 and magnesium are needed to neutralize estrogen in the liver. Thus, a deficiency may increase the levels of estrogen in the body. It also becomes something of a self-perpetuating cycle, as too much estrogen leads to a deficiency of zinc, magnesium and the B vitamins.

When eaten, the hormones, drugs, and antibiotics fed to cattle and poultry can wreck havoc to estrogen levels. Fish are far superior to beef or chicken in terms of hormone load.

Women who drank four to five cups of coffee daily had nearly 70% more estrogen than women who consume less than one cup of coffee. Tea is not much better. And for that matter, neither are soft drinks with caffeine in them like Red Bull or Mountain Dew.

Soy

As I did more research on the subject of estrogen imbalances, more things kept coming up. Most notable and perhaps most worryingly, is the effects of soy on hormone levels.

Soy alters hormone levels two ways:

1) Soy blocks the absorption of calcium, magnesium, copper, iron, and zinc in the intestines. These minerals are neccessary for healthy hormone levels.

2) Soy has high amounts of phytoestrogens. These are chemicals produced by plants that act like estrogens in the human body.

It is false to assume that taking large amounts of soy is healthy and good for you as “Asians eat soy as a staple” – this is what soy manufacturers want you to believe. Rice is a staple there, not soy. In Asia, soy is used mostly as a condiment (soy sauce is popular in cooking and has many forms in Asia). And when tofu is eaten, it is usually a side dish in Asia, not a main one.

Other popular soy products in Japan and South East Asia are miso and tempeh. However, these are heavily fermented forms of soy, which are safe and do not block the minerals necessary for healthy hormone levels.

I wouldn’t say that soy is evil, but anything in excess is bound to be bad for you. Thus, if soy is in your diet, take it in moderation only.

Update: There seems to be two schools of thought on this (perhaps more).

Blossom shared her thoughts on soy, “The isoflavones in soy attach to the body’s estrogen receptors and create a mild estrogenic effect, even in the presence of excessive natural estrogen, therefore soy can actually balance the effect of estrogen in the body if there is too much in circulation.”

If anyone has more helpful information on soy and/or differing opinions, please drop them in a comment and I’ll add them here.

Linda, a vegan, shared that the melasma on her upper lip improved after switching from soy milk to almond milk and lightening her soy intake.

Prolonged use of some drugs have been proven to cause hyperpigmentation for some people.

Because of its prevalence and widespread use, the most common culprits are oral antibiotics like minocycline (usually used to treat acne and pemphigus), tetracycline, and doxycycline.

The antidepressant imipramine, the heart medication amiodarone (to treat arrhythmias), bleomycin and cyclophosphamide (cancer drugs) have also been proven to cause hyperpigmentation in some users.

The list goes on to include chlorpromazine (an anti-psychotic) and phenytoin (for epilepsy).

Drug-related hyperpigmentation can occur both externally on the skin, teeth, and gums, as well as internally on the organs and bones.

On the skin, dark patches may occur on the face, arms, and legs, among other areas. Often, drug-induced hyperpigmentation is made worse by prolonged exposure to the sun.

Hyperpigmentation on the skin caused by the acne medication minocycline may start occuring from as early as one month to as late as 25 months. For further reading on this drug and the studies conducted, click here (a pdf file will open).

[On a separate note, another side effect of taking oral antibiotics like minocycline regularly is candida. If you have candida, you should consider taking yogurt, fermented food, or probiotic supplements to heal yourself. ]

The good news is that drug-related hyperpigmentation will often improve after some time once the person stops taking the medication.

3 essential tips before you do anything else

Firstly, be prepared that the road to righting your hormone imbalance is a process that may take several months.

Secondly, be encouraged that while melasma is a difficult condition to live with, you are not alone. Find a friendly forum and other people with melasma to share your thoughts, questions, support and progress with.

Here are a few forums and discussion threads on melasma to get you started:

Thirdly, be gentle. If you have melasma, the chances are high that aggravating your skin with harsh chemicals and scrubbing will only darken the melasma. For some, melasma even darkens from external heat, such as a hot bath or using a hair curler or dryer.

Important supplements to right hormone imbalances that cause melasma:

MSM

Vitamin C

CoQ10

Zinc

Probiotics (good bacteria)

Calcium D-Glucarate

Why do these supplements help?

Both Zinc and Vitamin C help lower copper levels, while MSMincreases the permeability of cells allowing the copper to easily move out of the body as waste. CoQ10 helps to boost cell turnover.

The liver breaks down estrogen and sends it to the intestines to be eliminated, but once there, bad bacteria can re-convert it back to estrogen. Good bacteria like L. acidophilus helps prevent this from happening by competing with the estrogen-forming bad bacteria. You can ensure that you have enough good bacteria by taking it in capsule form (widely marketed as probiotics) or naturally through fermented foods like kefir, yoghurt, tempeh, miso, and kimchi. You can read more about why it’s so important for us to maintain a healthy gut here: Keep your gut healthy – it’s your body’s second brain!.

In the same vein, calcium D-glucarate inhibits beta-glucuronidase formation in the gut. Beta-glucuronidase is a “bad enzyme” which promotes estrogen reabsorption. Calcium D-glucarate is found in fruits like oranges, apples, and grapefruit and vegetables like broccoli, cabbage, and brussel sprouts. Its also available as a supplement.

In relation to this, also avoid taking oral antibiotics on a regular basis. Antibiotics kills many types of good bacteria in the intestines and actually helps bad bacteria to thrive, which raises estrogen re-absorption in the body.

Eating more fiber also helps your body get rid of excess estrogen. Adding fiber through cereals or supplements shortens the transit time of your bowel movements. Shorter transit times means less estrogen is reabsorbed on its way out.

Comments from readers

Melasma fading and “breaking up” with castor oil applications

jj c wrote, “I have been using cold pressed Castor Oil (Hexane-free) on my face every night for the last week and have noticed dramatic improvement of the texture of my skin. The melasma is starting to break up slightly and think that if I continue this regimen, that my face will be clear and beautiful by the summer. I just swipe the spots with a castor oil soaked cotton ball after I wash and can actually see some brownish stains left on the cotton ball (the hyperpigmentation of my skin?). I then coat my face lightly with castor oil right before bed each night.”

Jill wrote here (below a separate article on castor oil), “I’m on week 3 of my castor oil treatments and my face is evening out nicely. The melasma under my eyes are breaking up so much that I can see normal color skin emerging from between the slight discoloration, which by the way, used to be much darker. Strangely, my eyelashes and eyebrows look fantastic and very full. I’m sure I’ll need a couple of months altogether to start seeing dramatic improvements, but I also realize that the discoloration took some time to develop too.

On a side note, I have not had a single pimple from this treatment thus far. I usually get one or two a week. I didn’t realize this would be such a great acne prevention solution too. I use nothing else but a thin layer of Castor oil as my nighttime moisturizer. I just thought I’d point that out to anyone wishing to use this to try to treat acne.”

Melasma possibly linked to Calcium deficiency

In her search for a solution to her melasma, Sandra wrote in a comment that she believes hers was caused by a calcium deficiency. She also pointed out that the medications listed on this page can lead to calcium loss.

Sandra wrote, “Thanks for posting this website. I have melasma on my face and I have frantically been searching for a solution for years. I have to say that after all my reasearch it boils down to calcium deficieny. If you google hypocalcemia and hyperpigmentaion, you will find loads of information about photosensitive hyperpigmentation. Even the pictures of hypocalcemia patients are similar to the melasma on my face. Reasearchers are now reporting the BC pills cause women to have low calcium. All the medications you have listed on this site are hydrochloride derivatives – hydrochloride is a calcium antagonist. Just get Calcium supplements with no vitamin D (vitamin D is actually a hormone and you don’t want me to get started on that one…) Nivea has mineral oil and it should be used in the daytime because mineral oil is an excellent sunblock.”

Melasma fading with supplements

In June 2011, Maria wrote “I have been taking Coq10, milk thistle and acidophilus probiotic daily for almost a month now.

I apply apple cider vinegar and water on the dark spots every nite before i shower and I also apply enough spf 30 (uva & uvb) anti-oxidant enriched lotion twice a day.

I can sincerely say im starting to see a difference and im so happy and excited i can scream of joy.

I’ve had these marks for about 5 yrs now so i know they wont go away over night but any progress is a great feeling. I wish i had known about this before 🙂 “.

In July 2011, she gave an update: “my spots look so much better & lighter… i should be happy but im not… i need to find a way to prevent them… “

In August 2010, Maria added that maca powder may have also helped. She said, “i use MACA 3 days before my period & during my whole period… then i stop & do it again 3days before my next period & so on… believe it or not… it helps me with my period, cramps & mood swings… i don’t know if this has ANY connection with my hormonal balance and my spots… i didn’t do this for my age spots but for my period…but i just thought i should put it out there…”

leili wrote that her melasma started after she took antibiotics and that she has noticed fading after taking MSM and Zinc. She also started to take extra Vitamin C and stopped eating chocolates and “noticed a big difference in two weeks”.

Melissa had fading with this regimen: “I have been taking the MSM and last week added a C, Zinc, Magnesium, A supplement plus grapefruit seed extract, and have taken Apple Cider Vinegar a couple of times and also applied it topically at night. I have to say there is definitely considerable fading plus light patches appearing in the middle of what were consistently darker patches previously !! VERY happy with the results so far, I will continue on this program and report back”

She later came back with a progress report, “Hello I am back after Christmas and New Year to report on my progress. I have changed to a Hair, skin and nails complex plus Milk Thistle (liver tonic) and Fish oil. Plus MSM when I remember but I have hardly touched it over the holidays. I have had several people say to me they notice the difference and I can see myself clearing on the cheeks and starting to get lighter patches around the hairline and more spots where the normal skin colour is coming through (yay !!). I went off my BCP 3 months ago and it was Diane Estrogen only so I was no doubt Estrogen dominant. Lost 5kg in about a fortnight too so bloating was a definite side effect. Feeling 100% better than I was, I had daily headaches to the point of migraine and living on Ibuprofen. So in summary I think getting the estrogen levels down plus getting healthy by eating really well, exercising and detoxing the liver a bit seems to be working nicely !”

Anonymous reported an 80% fading of her year-long dermal melasma with the following routine she very kindly shared. She had results in one month.

She applied apple cider vinegar (mixed with an equal amount of water) on her face for an hour each day.

She put on honey as a mask for an hour each day.

When she had more time, she put on a mask of lemon and cucumber paste for an hour.

She also took these supplements.

GSE, 100mg taken 3 times a day (I assume this is Grape Seed Extract, but could also be Grapefruit Seed Extract.)

Vitamin C, 500mg each day

Beta-carotenes each day

Deedub had encouraging results after just two weeks of supplementation.

FreeRadical reported her melasma is disappearing as she strengthened her liver. She wrote:

I have tried both prescription and alternative treatments for my melasma. Mine was (it is currently disappearing) on my forehead, cheeks, bridge of my nose, upper lip and a little under my eyes. I didn’t find much success in hydroquinone cream 4% combined with Retin-A (although I love retin-A for different reasons). Vitamin C, taken orally and topically (in the form of active Vitamin C ester), does work a bit.

For me, the issue is liver function. The liver synthesizes hormones and cleans them from the body. My problem with melasma started after having my gallbladder removed. Most people with gallstone obstructions are overweight, estrogen-dominant women. I am not over-weight or estrogen dominant, but since the gallbladder stores bile and helps the liver supplement bile excretion, my liver function is compromised. I’ve noticed that I became intolerant to many drugs that previously were not an issue – they caused my serum bilirubin to skyrocket. Bile sequesters waste products and helps detox the body, so anytime bile flow is obstructed or reduced, there can be problems.

My cure has come as a result of addressing my liver function. I am taking Milk Thistle (Silymarin), Artichoke, Turmeric, Dandelion Root, Zinc, B6, Magnesium and Vitamin C. It is working amazingly fast and well! It sounds like a lot, but it is worth it.

Plus, my liver function is improving. I believe that melasma CAN BE a symptom of internal disease (in my case, liver problems). There’s evidence that artichoke is more effective than Milk Thistle in detoxing and protecting the liver and I added it after seeing a remarkable change from taking Milk Thistle alone. I may add Vitamin D Glucarate to see if it works but be aware that Vitamin D is a PROHORMONE (it is a precursor to hormone formation). Therefore, if you are estrogen dominant or otherwise have a hormone imbalance, proceed with caution. Of course, I’m wearing sunblock but take care to use a product that doesn’t have estrogenic effects (apparently some of the ingredients in many sunscreens mimic hormones).

One of the most effective liver supplements I’ve been taking is SAM-e. If you are on certain types of prescription drugs for depression or bipolar disorder – do NOT take SAM-e without consulting your doctor. It can be bad for your heart (it is like taking massive doses of your prescription drug – bad!) But for me, SAM-e has been great, almost miraculous, because it helps my liver and melasma but there’s no bad side effects. For those who are curious, I take Jarrow brand 200 mg extended-release tablet of SAM-e once a day. SAM-e degrades easily, so go with a reputable brand.

Anonymous said her melasma (which she has had for four years) improved 25% in about a month after taking MSM + Vitamin C + Cod Liver Oil. She said there was a definite change in the intensity of the melasma patches on her cheeks and nose.

Recommended sunscreens for melasma

Anonymous recommended a brand called TiSilc. She wrote, “A good sunscrean is TiSilc, it comes in 45 or 60 SPF (tinted or sheer/clear). It’s excellent. I have had melasma from many many years of bc and mild/mod sun exposure, before melasma was even a medical condition on the bc labels (back in the late 80s) my skin has never gotten back to the shade it was pre-bc. Tisilc will def block the sun though – use it every AM for the rest of your life.”

Mama lotion

Laura reported that her melasma has lightened up considerably (“to a point where my tan patches are starting to look a reddish/pinkish color, and fading”) after three weeks of using Mama lotion, which is a mixture of malic and mandelic acids. She says that the product’s effects is significantly close to dermabrasion.

L had a different experience and wrote, “I tried mama lotion for 6 months, and there was some patchy improvement, but it made me peel/flaky/dry – and the melasma came back immediately when I stopped using it every other day (which I am loath to do because it is so harsh).”

Colon cleansing

Mary Locklear wrote that cleansing her system led to her melasma breaking up in some places. She wrote (excerpt): “About 2 years ago I started doing colon cleansers, and I think that that helped, because I could see breaking in some places on my face. The product is called colonix (Dr. Natura.com), and it is about $78.00 and is worth every penny. It removes yeast, poisons from your intestines, and you feel like a new person, and I noticed a little improvement in my melasma. Your organs can do their job a lot better when your intestines are cleared of years of parasites and caked on fecal matter. I will be observing my skin closely in December when I do my yearly cleanser. “

Blue Obagi peel

j75 had poor results with dermabrasion, a TCA peel and hydroquinone. She had better results with a Blue Obagi peel.

She said (excerpt): “I started seeing the large patches break up after about 2 weeks. Then I went in for my scheduled light BlueObagi peel. It starting tingling/burning a bit and she gave me a little fan to hold – then she washed it off. It really wasn’t that bad. When I left I couldn’t tell any difference. She applied a thin layer of lotion/moisturizer and gave me the tube to keep using. I used it everyday like she said so that when my skin started healing from the peel, I wouldn’t notice any redness or skin flaking. It worked. After a couple of days I even put a little foundation on. Then after a few more days, parts of the top layer of skin started coming off. The skin underneath was so smooth, tiny pores, and the brown patches of melasma were gone! I couldn’t wait for the rest of my skin to shed/heal. All of the melasma came off. It’s been several years now and the melasma that was on my forehead, upper cheeks, and nose is still gone. Now, I’ve started developing melasma on my upper lip and lower cheek/jawline. I’m planning to set up another appointment to get rid of the new melasma areas.”

Related Posts

Cod liver oil contains vitamins A and D as well as Omega-3, which can help those with acne. The main difference between cod liver oil and other fish oils is that cod liver oil is high in vitamin D. Omega-3 can also be useful in helping treat psoriasis, eczema, and other skin diseases.

Castor oil has many medicinal and curative uses, and the same properties that make it so effective in healing the body also make it an excellent choice for maintaining beautiful and healthy skin and hair.

MSM (or methylsulfonylmethane) is a natural sulfur found in fruits and vegetables. High-sulfur foods include asparagus, broccoli, red pepper, garlic, and onion. However, most people are deficient as sulfur in food is lost when processed, heated or dried.

Hi Julia – I get my MSM from the pharmacy. Its fairly common so you should be able to find a few brands of them in any pharmacy or health food store.

Try to look for “capsules”, the pills can be harder to swallow. It also comes in powder form that you mix in with drinks.

About topical creams, I would suggest first finding out what type of melasma you have (is it dermal or epidermal?). Dermal melasma means the hyperpigmentation is deeper in the skin while epidermal is milder. If you have epidermal melasma, its generally responds better to topical lighteners like mandelic acid, kojic acid and lactic acid. I personally have used hydroquinone and do not recommend it – results with HQ vary and the melasma can lighten initially then rebound (get darker) if you stop using it.

If you find that you have dermal melasma, it might be better to focus on correcting things internally with MSM because topical creams might not have much effect.

Also go slow on your skin when trying topicals so as not to aggravate the melasma more, and finally find a good sunscreen (use it religously!).

I have had melasme for 15 years, due to birth control pills. My melasma gets darker in the summer and fades in the winter. I have tried every suncreen reccommended by my doctor yet it did not help as much as I hoped it would. I use Coppertone water babies on my daughter and noticed that it protected her so well that she hardly even tanned. So, I tried using it on my face this summer and my melasma is still as faded as it was all winter. I love it! Try it for yourself.

Thanks for the information on melasma
1. Any success with Pynogenol?
2. I had my blood tests and my DHEA was low. My progesterone was slightly lower than my estrogen. Doc recommended taking progesterone before my peroiod but I am afraid to make melasma worse. Should the hormone levels be evenly balanced?
3. MSM- Can I get this at the Vitamin shop? or GNC?
4. I will try coppertone for bablies any other good sunscreens?
5. What dose of MSM?

3. MSM- Can I get this at the Vitamin shop? or GNC?
Yes, you should be able to find it in both shops.

4. I will try coppertone for bablies any other good sunscreens? If you can find something with zinc oxide in it, that would be better. However, most sunscreens use titanium dioxide.

5. What dose of MSM? For melasma, the recommended dosage is quite high (8gms and upwards). But start slow with 1 or 2 gms a day because your body will go through an uncomfortable purging process in the beginning. Refer to my post on msm for more.

Hi Ellen, I have recently updated the article on melasma. I mentioned the hormone ratio now, it shouldn’t be 50:50 or evenly balanced.

I noticed that pycnogenol (which is a powerful antioxidant) is mentioned in the page I recommended as a method to remove excess estrogen from the body. You might be on to something here, but I can’t attest to the efficacy personally as I’ve never tried it.

Thanks Samantha! It is amazing because I am 35 and I just went to an anti aging doctor and we talked about bioidentical hormones, balancing, my estrogen and progesterone, taking vitamin supplements.
Since I am no longer on the birth control pill but still have terrible melasma, I thought maybe the imbalance was causing the condition???
I am now taking progesterone on menstrual day 14-25 ( not sure if I will be even) Estrogen is 360 and unsure progesterone. But I will ask my doctor and I will let you know if it gets better.
Is there any vitamin brand that you like? I bought Solgar, I heard New Chapter and Life Extentions was good.

Hi Ellen, if you have trawled the skin forums you’ll find a lot of similar cases to yours (women who have stopped bcps for some time, but their melasma persisted for years). Its not clear why hormone levels don’t right themselves when birth control pills are stopped. In any case, I think you’re doing all the right things – checking your hormone levels will also keep track of your progress and let you know what works and what doesn’t.

Btw, if you’re taking progesterone, you might want to make sure its natural and not synthetic progesterone (also called progestin). (The problem with some birth control pills is that the progresterone in them is synthetic, and thus ineffective in countering the estrogen).

On that topic, there was a study that found “progesterone is ineffective when given orally”. I’m not sure how true this is but if you find no progress in hormone levels with the progesterone supplement your doctor recommended, you could try a progesterone cream that’s applied topically on your skin instead. It might be better absorbed this way since it won’t bypass your digestive system.

Oh and to answer your last q, I don’t favor one brand over the other. I use NOW MSM these days because I can get it in bulk at a nice price and comes in a capsule (not a pill) which is just my personal preference. But if you can, try looking for a brand with the optimsm or lignisul logo on it because its supposed to be of better quality.

I’ve never tried those brands you mentioned, but if the MSM is working you should feel the purging effect relatively quickly (anything from headaches, to feeling feverish, and more frequent trips to the bathroom. )

Hi Ellen, your headaches should go away over time. You can lower your dose to just 1 gm per day if it gets too uncomfortable. If you find that they persist after one week with the lower dose, pls stop taking MSM. I’ve not heard of allergies to MSM before but anything is possible, so pls monitor your pain and take care of yourself.

MSM causes headaches because your cells will suddenly become much more permeable, which means that waste matter will more easily be released. This sudden release of toxins is what leads to feelings of uncomfortableness in the beginning, including headaches and falling ill.

But good things also happen as cells become more permeable, nutrients and oxygen can more easily enter the cell walls as well.

When I took MSM the first time, I didn’t have headaches, but I started out at 1gram/day because I was chicken. My main reaction was going to the toilet more. 🙂 I also had a lot more energy suddenly and waking up in the morning, I didn’t feel as drained as I normally would.

Ellen, high copper foods to avoid are dark chocolate, shellfish, meat organs – like liver in particular, nuts, peas, and whole wheat. There are many foods that contain copper but these are the ones with the most.

Abt your results, I’m not a doctor so I was a bit stumped by your ratio. It looks very high that at first I wondered if you had mixed up estrogen with progesterone.

Hello, I wanted to share a skincare product that has changed my life (no, I am not getting paid by them, I just know how upsetting melasma is). I went for my botox tx and the consultant noticed my skin (always upsets me), anyway she recommended a laser tx (way too costly) and when I told her I could not afford she reommended OBAGI-C RX system. To buy from her it was $350.00 for the six piece kit. I went on the internet and found it for $280.00 @ skincaremd.com. There are a lot of sites to buy the products, but I bought the kit. I LOVE LOVE LOVE this. My melasma was bad on my cheeks, and I had to be VERY careful in the sun because it would darken. My pores were big around my nose and my skin just looked horrible. I noticed a HUGE difference after 2 days kid you not. First thing was the area near my nose where my pores where big began to flake and after a few days of that the large pores where gone. I am about one month into using it and my skin looks amazing. Spots GONE!!!!!! It actually glows and now in the morning, instead of spend soo much time w/make up and trying to hide my skin, I literaly take a dab of foundation and that is all I need. I wish you all the best and hope this info helps. It is WORTH every penny (think of the money you will save in makeup and products alone!!)

I have heard of Obagi however, I am a pharmaceutical rep so I am in the car all day. (exposure to the sun) How sensitive is your skin to the sun with Obagi? and what sunsccreen do you use?
I need something. My melasma is so upsetting. I am taking the MSM which I feel hopeful.

Lastly, what are some the skin forums? I am always looking for treatments with melasma.

Hi Ellen, this place is a good, pretty active forum just for women (and men) with melasma.

Also, essentialdayspa has some good threads on melasma, I’ve listed a few below. But pls read them thoroughly and decide whether the options are right for you. For example, some people have had their melasma darken further because of cosmelan.

Thank you! I definitely will take it slow. I feel good on the MSM even after a couple of days so I may increase the dose. Right now I am using the sunscreen and not sure what cream I will try. I had the same experirience with Hydroquinone. It really didn’t help me. Do you have any thoughts on the Obagi or any cream that you felt really helped?
My lip is fading slightly but I have also stayed out of the sun. I wonder why the lip fades first for most people.

I am so happy to have found this site. I am 30 years old and started noticing a dark area above my upper lip about 1-2 years ago. I had heard of pregnancy mask and because I have 3 children (youngest is 2), I contributed it to that. I since have had a quarter size brown spot develop on one side of my cheek and a slightly smaller one on the other side. These have developed over the last 8 months. I do not use birth control anymore, but did use the pill for nearly 15 years (aside from my 4 pregnancies..miscarried in January) I have also spent my whole life in the sun. I am blessed with great skin tone and never burned so I never wore sunscreen before now. Can anyone tell me that If I start taking precaution (sunscreen, no more b.c. pills), can I expect that I will not get any more melasma? I also read that apple cider vinegar can help and I have been trying it for about a month. My friend and husband who have been monitoring it with me can see a difference. I do too! I also use the Neutrogena Even Skin Care wash, mask and lotion. It’s an inexpensive line that is supposed to even out “dark spots”. I have started using babies’ spf 60 everyday. I will start taking MSM and use C serum. I do not like the idea of peels and because I have naturally tan skin (bi-racial), I’ve heard that peels and many prescriptions can worsen the problem for medium-darker skin. My worse part is my upper lip. Is there anyone out there that has medium-tan -darker skin tone that has found an inexpensive treatment for this? Does it really get better over time after kids/ no more b.c.? Thanks for all the great info!

Hi Kim, congrats on your success with apple cider vinegar. & thanks for sharing the tip here. I wrote a post on ACV a while ago though I was recommending it for age spots then. How do you apply yours? Pls let us know if you have a different method.

And I do hope that your melasma fades after you stop BCPs, but theres no way of knowing until you try it. I wish you all the best.

Its true that peels can be a risk to darker skin types, so I’m happy to hear that you’re taking it slow.

I experienced my first melasma (mustache, yikes) from bcp and lots of sun due to increased jogging 12 years ago. I went to the derm. and was treated with Azelex….it worked and I was melasma free for quite a while and never went back to bcp’s. Fast forward to my first pregnancy 9 or 10 years later. I experienced a growing patch on my forehead because I nursed my first and second child, never saw the melasma abate, but expand. I associate the melasma with the added estrogen from two babies and extended nursing. Right when my daughter should have weaned, my son was born, so until this week I’ve been nursing for the last 4.5 years (my son just weaned himself, thank god!)

Anyway, a more natural-minded doctor told me that the synthetic chemicals/hormones from bcp are never processed out of your body. Since they are synthetic the body can’t really process them, so it just stores them. Does this sound right to you? Also, if this IS true it could be the reason melasma persists even after bcp are discontinued. I suppose digging up some research could tell us definitively if bcps are processed out or stored.

also, as an addition to the above, has anyone had success doing a fasting cleanse to get rid of melasma? Maybe a powerful whole body cleanse/detox would allow our systems to release whatever is hanging around and causing the melasma.

Vicki and Samantha,
You may have something there because I have never been pregnant. I took the bcp pill over 3 years ago. I still get melasma on my cheeks and forehead every summer. MSM which we talked about earlier has the same effect as a detox but I think a full detox might be something to try. I am taking the MSM for 2 weeks and no change. Smantha what do you think?
Ellen

I’ve checked and its true that synthetic progesterone (progestin) is more powerful and has a longer “half-life” than natural progesterone, but it doesn’t seem to be longer than one day. Here’s a chart of the “half-lives” of some progestin BCPs, with the bottom numbers being hours.

I couldn’t find any reference that traces of progestins might remain in the body forever though. Its a disturbing thought, but its possible. Some toxins like mercury can remain in the body for decades. If its a similar case for bcp traces, then the idea of doing a detox/liver cleanse might makes sense.

p.s: the “half-life” of something refers to approx time needed for a foreign substance to lose 1/2 of its potency naturally, without any help from the person (e.g. being expelled through bowel movements or sweating).

p.p.s: Ellen, 2 weeks is really too short a time to decide if MSM is ineffective for your skin or not. Skin renews itself only every 28 days or so (slow, I know!). This means that your top layer will look the same until it sloughs off to show your newer cells underneath. I’d encourage you to give it a minimum of a couple of months at least, just because of this alone.

Thank-You for having all this interesting information! I’ve been on Thyroid medication for 14 years and have melasma for approx.10years. I’d like to start using the MSM w/vit.C. Do you know if it’s ok to take daily vits. along with this and my Thyroid medication? Also, what is CO Q10?

Its safe to take MSM with thyroid medication as its a natural substance found in food. In fact, taking MSM will make your thyroid medication and other vitamins become more effective because MSM makes cell walls more permeable.

Like MSM, CoQ10 is also naturally found in food, plus our body even makes its own CoQ10! Its what powers our cells and generates energy for everything our body does – from keeping our hearts beating to skin cell renewal/repair.

Its also useful as an added supplement because our bodies make much less of it when we reach adulthood (compared to when we were children).

I am 33 years old, today was told the brown patches my sister and I get is Melasma. My sister just developed hers this year after a trip to Hawaii, mine began 10 years ago.

My sister took the pill, about 5 years ago, has a son 8 years old and only last month got the dark spots. I took Depro Vera for 6 years, developing the spots about the 3rd year. The first year I took depro I got a dark mustache type spot above my lip in the sun. Now I get no mustache but will see the spots darken after a few minutes outside on a sunny day. I have never been pregnant, only used Depro Vera a synthetic contraceptive but my sister is opposite of me in every way. Most my friends have the spots, and took birth control only 1 gets the spots after she quit.

It might be very easy to gather info on the reaction of a male to Depro Vera. Depro Vera is used as a chemical castration in some instances for sex offenders. Those men may have more then enough to accelerate this Melasma because women take a injection every 3 months, but men take it weekly but the doses seem to vary for the men.

My gut instinct says Depro was the cause of mine, but not everyone I know has used depro or if they use it not everyone has gotten the dark spots. I guess we have to manage our own health and well being, I saw a show about Depro and on my next appt asked the doctor who said no its not listed on the box. I reminded her the questionnaire I was given every visit from the receptionist on Depro had a question about skin discoloration, then I said I have noticed some sexually related problems. Whatever I said she took interest in, the next date of my injection we went to her office where she showed me her findings on depro, and she said I should consider not taking any birth control and hope my symptoms go away. The spots have not, and the Depro Vera is now labeled not to be used for more then 2 years as its can cause significant bone loss

I am 29 and ihave terrible dark spots on both cheecks and on my forhead and on my upper lip i have had lazer treatments that didnt help but was really exspensive every doctor i go to looks at me like i have 2 heads or something and they always say that its part of getting older and being a female this is taking a big tole on my life i dont like to go out and i never look anyone in the eye anymore it is very very depressing for me please if anyone can help me i would greatly appriciate it.

to add to my previous post i do not have kids and i have never been on birth control pills. i have dark hair and i guess olive to medium skin and now for many years wear alot of sunblock but to no avail i really hope i can somehow get treatment for this or get some ideas thanks

Please take heart – it may seem like a horrible problem and that you’re all alone in it but that’s simply not true. If you do a search for some friendly forums, you’ll find many, many supportive people who are going through the same thing, and some who have overcome it.

Btw, since you’ve been to see doctors I’m going to assume you have melasma and not the run-of-the-mill hyperpigmentation.

I wouldn’t recommend lasers again not just because its expensive, but because on darker skin tones it can lead to more dark patches. Darker skin is more likely to respond to laser burns with more melanin or with white patches. If you want to exfoliate, go with gentle peels instead of lasers. Weaker concentrations of lactic acid (e.g. 10%) are safe on darker skin tones.

Since you didn’t take bcps or have any kids, your melasma might have been triggered by other things like severe stress. If this is the case, then take more care in keeping your stress levels low day-to-day. Do the things you love the most, and try to focus on what makes you happy. Put the brakes on and shift gears when you find yourself in a downward mental spiral. And if its not stress, have you checked yourself for an inactive or overactive thyroid?

Thak you, thank you! I went to the doctor today, he couldn’t even tell me what was going on. i have a friend that suggested that my BCP was creating this havoc on my upper lip. The quack couldn’t give me any suggestion, luckily his nurse was pregant and knew exactly what was going on. I found ths site and went out and bought the vitamins at lunch. My husband has been snipped so i only use the BCP ease the pain and flow of my monthlt “friend.” I get migraines during that time of the month and the BCP help less the occurances. I am going to take a chance and see how it works. I would rather have migraines controlled by medication than this appearance. reading through most of these messages, i have noticed that most of you are about my age 34 give or take a few years. I prided myself on my dark complexion and was thinking about tanning beds this winter. I tried all the over the conter products and the nuetragena even tone was the closest think. the expensive stuff like Mary Kay stunk. I’ll check back in one month or earlier if any changes occur. i know it may take some time. I purchased MSM, vitamin c, and the CoQ10. I already take B6 and B12. Thanks for the advice on the lazer treatment b/c that was the next step…and it would have made the situation worse.

I have melasma, after my Elos RF treatments, it had became mucher darker than before.
May I know how much MSM and Vit C to take and any other supplements that will help to clear Melasma. What kind of food should I avoid taking.

I drink a cup of soy milk every day and also drink milk for calcium.
What kind of food should I eat to help melasma.

If its hormone related, you should look to lower your estrogen levels. For this I’d recommend taking food with live cultures (probiotics) like yogurt and Yakult, and also adding more fruits and vegetables in your diet, specifically fruits with lots of Calcium D Glucarate in them (like grapefruit). MSM, Vitamin C, and CoQ10 will all speed up the rate of cleansing, healing, and cell turnover. You might also consider taking Pycnogenol which is a powerful antioxidant and has been known to help some melasma sufferers. Here is a study on it. A fasting cleanse may also help your body get rid of excess estrogen more quickly.

And I’m not sure if you caught it in the post, but there is a warning on soy – ingesting too much of it can raise estrogen levels. You might want to cut down on those soy drinks and stick to cow milk for your calcium.

About MSM, you should start at low dosages of 1-2 grams per day and slowly increase to 8 grams per day. Vitamin C can be anywhere from 500 mg to 1000 mg per day, and this you don’t need to increase unless you’re healing wounds.

Thanks for your advice. I did went to pharmarcy to buy MSM and I asked the pharmacist how much to take and it’s for my melasma.

She said MSM won’t help my melasma, it only helpful for pains.
So I didn’t buy but I do take Glucosamin with MSM for a few years.
It contains about 400mg MSM, I only take once a day.
Right now, I am increasing it to 3 times per day.
IF MSM really help melasma, I will buy MSM to try out for few months.

How much yogurt should I take daily? Also, it’s okay to drink coffee or tea? I used to eat dark chocolate every day for health reason. I also started to drink soy milk one year ago, they said it’s good for menopause.

I am only 22 and developed melasma. I have never been pregnant or on the birth control. I did go through about 5 months of intense stress. A couple months later was when I noticed my melasma. I went to a naturopath and she tested my estrogen and progesterone by saliva. My progesterone was low and the clinic recommended natural progesterone. I am waiting for the results for my cortisol levels.
I also just bought some acidophilis. Can you please tell me if my low progesterone level could have been the cause of my melasma? Can stress cause hormonal imbalances?
Also, how does acidophilis help melasma?

Hi Beng, I doubt most pharmacists would know that MSM has helped some cases of melasma and it won’t be listed on the bottle either. One lady has written a book about it (her name is Vanessa Wild) and this has spread the word. Apart from the book, most of the user accounts of MSM’s success can be found in forums from people sharing their experiences, so its not documented or very scientific. If you do a search on this site http://skincarerx.com/phorum/list.php?3, you’ll find a lot of those accounts of successes (and similarly, tales where MSM didn’t help). I advice you to read them so you can make a decision on whether or not to try it.

To answer your questions, one cup of yogurt per day should be enough to get your started. You don’t have to eat it everyday forever, just long enough to get your good bacteria going again (if you lack it). After about a month, this should be achieved, and if you keep up with a healthy diet the bacteria will continue to live and multiply on its own.

Coffee and tea is okay, but try not to drink too many cups per day (like 4-5!) because too much can raise estrogen levels. And if you take MSM, you should think about including some Vitamin C, because these two work very well together. Eating more fresh fruits and vegetables is a good idea also. About the other foods, I do not think you should stress out too much about what to avoid. They all have nutritious value (even spicy food) and should not do harm in normal amounts. Its only a problem if you overdo something (e.g eat/drink a lot of one item, and do this everyday).

I am only 22 and developed melasma. I have never been pregnant or on the birth control. I did go through about 5 months of intense stress. A couple months later was when I noticed my melasma. I went to a naturopath and she tested my estrogen and progesterone by saliva. My progesterone was low and the clinic recommended natural progesterone. I am waiting for the results for my cortisol levels.
I also just bought some acidophilis. Can you please tell me if my low progesterone level could have been the cause of my melasma? Can stress cause hormonal imbalances?
Also, how does acidophilis help melasma?

Hi Ange, sudden and prolonged periods of emotional stress can definitely alter hormone levels. There have been documented studies where women developed melasma after periods of sudden stress.

One theory as to why this happens is that stress leads to the release of “melanocyte-stimulating hormones” from the brain. Stress is also one of the things that can reduce progesterone. For more reading about this, check out this page and scroll down to point 7 (Stress causes adrenal gland exhaustion and reduced progesterone output).

L. Acidophilus and other good bacteria in the intestines helps to metabolize/break down excess estrogen. Like most other substances in our body, hormones also need to be passed out as waste matter regularly (while new hormones are secreted). This cycle of creation and removal keeps us ‘balanced’.

But if the removal process is blocked, an excess of estrogen will occur. If this is happening, then supplements of good bacteria like L. acidophilus will be very helpful.

Hi Ange, yes I’m on MSM (on top of other supplements) and have been for some time. So far I’ve had some slight breaking up which I count as progress, though its extremely slow in coming. I even see these lightish spots (or speckles as I call them) appearing on parts of my body where I’m more tanned, especially on the backs of my shoulders and the top of my arms. But I don’t know if others have had this happen.

Hi Ange, in one of the comments, Becky recommended Coppertone water babies to be very effective. So if you’re not happy with the one you bought you might consider trying it. I haven’t used UV Naturals so I can’t say how good it is. But if it contains zinc oxide, that’s a good thing (ok now I sound like Martha!).

This probably sounds weird but I’m using a medicated talc powder for an all-over sunscreen. I initially bought it for a sunburn but when I got home I noticed it had 9% zinc oxide in it, so I’ve been using it ever since. On my face, I apply it under my makeup. Although I don’t know how effective it really is, the good thing is that I have no problems putting it on everyday. Before when I was using regular sunscreens, I often skipped days because the sticky feeling bothered me so much. But that’s just me!

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